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| I'm pretty excited tonight because I filled out the last FAFSA application I'll have to see in my entire life. (Hopefully). It's weird, thinking about how many of those things I've filled out. And it's always comical when I get to the part about my income, any taxes I'll be paying this year, etc, etc. I always breeze through them, typing in empty, hollow "0's" in each box.
I'm in the middle of my neurology rotation. I have a patient who was in the Special Forces Marines for several years and after 2 traumatic brain injuries (among many others), he's left with chronic pain, narcotics dependency, post-traumatic stress disorder, and psychogenic seizures everyday of his life. Which basically means he has seizures that can't be treated medically, only with psychotherapy, and often not successfully even then. And he's in his early 30's. Sucks. He's a really nice guy, too. He received 4 Purple Hearts and everything. You really can't judge him for anything.
After doing my surgery, pediatrics, family medicine, and part of my neurology rotation, I think I may know what I want to do: pediatrics. Because in pediatrics, you can subspecialize and do anything in medicine you could possibly want to do. But your patients are cuter. I'm kind of simplistic like that. That's how I'm looking at things right now, anyways. There's less judgment placed on kiddos for their health problems (unlike adults who smoke, eat bad things, and don't exercise), and I don't mind the parents too much, which is the deal-breaker for most people. I kind of like educating parents on how to take better care for their kids. And I want to punch any parents who abuse theirs.
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| Crap...this journaling venture did not pan out the way I had hoped it to. I guess this can be an abridged version of the past two months.
-Did 3 weeks of ENT. Conclusion: I do not like ENT. Looking down someone's throat with a scope was, in the end, not as exciting nor thrilling as I had hoped it to be. Shame. I really liked the people. Although I did see a patient with a neck mass about 12 x 12 cm. That was weird to see. It was basically resting between his shoulder and smooshing his ear.
-3 weeks of pediatric surgery = 3 weeks of hell ameliorated only by my team. Most days, wake up somewhere between 2:30-3:00 am (I quickly learned to forego showering to get an extra 15 min), get off work at 5:00 pm, eat dinner, stare at the wall, and then go to bed by 8:00 pm. No, I'm being a little dramatic because I saw all the "zebras" that you only get to read about in textbooks: Marfan's, Klinefelter's, Dwarfism, pyloric stenosis, Hirschsprung's disease, gastroschiesis, an ECMO (basically like a dialysis but instead of a machine acting like your kidney, it works like your LUNGS). And like I said, a good team which can make or break your rotation alone. It was just the surgeons that were...challenging to appreciate. And also when going into work at 6:00 a.m. meant you got to sleep-in...I guess it was comical in retrospect. And never again will I ever be so excited about a patient having a bowel movement or passing gas.
-At the end of my surgery rotation, I went to North Carolina for the weekend to visit my brother/aunt/uncle/Anna. It was a busy weekend. And also coincided with Gay Pride weekend at Duke so that was interesting. I visited D.C. during their Gay Pride week over the summer, as well. It follows me. Anna's becoming crazy cat lady, brother's shooting guns at mean sheets of paper, and aunt and uncle are opinionated and judging as ever.
-Started Rosetta Stone to learn Spanish. I was known by my peds surgical team for my complete lack of effort in pronouncing Hispanic names correctly. As a psychiatrist attending (unnamed) said to Chase, "The only Spanish I know is 'taco' and 'burrito.'" Amen to that.
-Currently doing heme/onc outpatient for my first pediatric rotation. It's been one week, and I love it. First of all, I got off today at noon, so already extra points. But on the serious side, I do see lots of interesting patients with leukemia, sickle cell disease, sarcoma, brain tumors, and so on. People always ask me if it makes me depressed, but my patients are finishing up chemo or just getting their annual check-up, so they're success stories. We had a brother and sister come in with severe thalassemia (form of anemia) who were refugees from Iraq and we needed a phone translator to do the exam. I also did 5 lumbar punctures and 2 bone marrow biopsies which was pretty awesome.
-Trying to appreciate Chase's love for Aqua Teen Hunger Force. I bought the DVD for him (stupid me), and I try so hard to find the funny in it. Although he insists we need to see it multiple times to get the most out of it. Don't know if he's just trying to trick me into watching it a lot with him.
-I miss reading novels. And doing art.
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| It's the beginning of the fifth week of my surgery rotation, the first rotation of my third year. In retrospect, I should've begun documenting this journey from the start because I know there's been many moments that are worth remembering. Unfortunately, I don't remember many of them anymore. I've begun to realize that my memory has been on a steep decline for some time now. For instance, when a doctor pimps me on a subject I read a few days ago, and all I can respond with is a blank stare and the dewy perspiration of panic. I guess while I have this time in front of the computer, I might as well try to recall some noteworthy anecdotes. To set the stage, I've been on my general surgery in private practice at the Methodist Hospital. Private practice, in a word, is "cush." But the reason I requested to rotate through Methodist wasn't the free food in the doctor's lounge or the 8:00-5:00 days, nor was it the weekends off or nicer OR facilities. No, while I have definitely been enjoying the private medicine lifestyle, what I was looking forward to was the abundant OR time, more hands-on involvement in the cases, and the chance to work under Dr. R, one of the best surgeons/doctors in town. And I'm just quoting Texas Monthly when I say that. So things I've learned so far: 1.) Respect and be kind to everyone, from fellow doctors, to nurses, to patients and their family members. Do that, and everything will come back favorably to you in the end. Dr. R is definitely an example of that, and when I was rotating with him, so many people kept telling me how lucky I was to work with him. Nurses would bring him tea and cookies, patients completely trusted his decisions and skills, and other doctors sent their family members to him. 2.) "Availability, affability, ability." Dr. M, a retired surgeon who seems to not understand the word of "retirement" and continues to work 50-60 hours a week, told me this during lunch one day. That was his secret to success, ranked in order of decreasing importance. Be available - that's how to build a practice. Be affable - see #1 above. Be able - important, but only third in the list. And it's true, I see it in Dr. R. His patients only see his plastic-surgery-quality surgical scar, and they don't know what went on in the OR, but they trust him because of his demeanor. 3.) Sometimes you get to connect with a patient - hold onto that and recall it during the harder times. When I was on-call in the ER, an elderly women came in because she fell off a ladder and severely fractured her ankle. While I held her hand for two hours during her bouts of pain despite loads of painkillers, we discovered that she had a masectomy done by Dr. R. and we were both Plan II alums. She explained to me Descartes' ball of wax theory (I asked her about that to keep her mind distracted) because she was a philosophy professor. She kept thanking me for staying with her, and while I never saw her again, I kept up with her records to see she made it through her orthopedic surgery and rehabilitation. 4.) Don't take things personally. Sometimes people have bad days. 5.) Expect to feel stupid. Like for instance, when the surgeon asked me what hormone the thyroid makes, and I fumbled around for about 5 minutes until my brain stopped farting and remembered it made "thyroid hormone." I wanted to bang my head against the table, but the patient we were operating on was laying on it, and that would definitely have broken the sterile field. 6.) Speaking of which, don't break the sterile field. Think twice if it's covered in blue. This is certainly not all that I have learned in surgery, but my stomach is rumbling and I'll have to pick this up again at a later time when serendipity finds me in front of a computer again. | | |
| I went to my first drug rep dinner tonight. It was at a really fancy restaurant called the Lodge, and it's featured in a book of top "spectacular" restaurants in Texas. (Their word, not mine). The building used to be a mansion, and we had the dinner in this smaller cottage-type house adjacent to the mansion. Four courses: salad, orecchiette pasta with duck confit, salmon with pineapple salsa, and a "Nutella souffle-inspired flourless cake" which I would sum up in a word: "decadent." Top that off with a couple glasses of wine, and now I'm sitting here trying to "inspire" myself to study for my pharm final that's on Thursday. Let me tell you, life's hard at times. Chase got invited to this dinner by his residents who got rewarded with this dinner for the best attendance at lunch conferences. Whatever, a room full of doctors, a little promotional talk for a new insulin pen, and I get an excuse to stop studying for a few hours.
An aside: Gina gave me some gummy vitamin bears that tasted good, but now I have this chalky, nasty aftertaste that's bugging me.
Earlier today while studying, I looked out the window and saw one of the campus landscapers removing old flowers from some giant pots we have in front. I liked watching him work because you could tell he enjoyed doing what he was doing. He would carefully dig his trowel into the soil, lever the roots out, and gently shake out the soil from the root hairs before throwing the old flowers into a plastic bag. It seemed a job that could be hastily done, but he took a lot of great care in doing it. If the plant was still producing flowers, he placed it in a smaller pile on the truck bed. I wondered what he was going to do with the good ones - move them elsewhere? put them in his own garden at home? It made me want to garden. I couldn't help but think of the analogy of God separating the sheep and goats (which always made me wonder, what were so bad about goats and so good about sheep?) except in this case, he literally threw away the plants that weren't producing fruit and kept the ones that were. Anyways, that was my deep thought for the day.
By the way, this entry's for you, Paul Park. 
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| Yesterday a bunch of medical students were studying for our psychopathology exam at Starbucks. All of a sudden, a women came out of the adjacent Chick-fil-a and started walking around the parking lots and shouting things (I was inside studying, this is based on eyewitness accounts). She eventually made her way onto the street facing Starbucks (and overly-interested customers). People began to approach her (to help her and calm her down), and in response to this, she took off her clothes and began to roll around on the ground until EMS came, covered her in a yellow, plastic tarp, and took her away.
According to Chase, psychosis is when something inside a person is telling them an unconventional action in response to their environment is "a really good idea."
Needless to say, psychopath suddenly got a lot more interesting after that.
On a somewhat related note, I think public health efforts to reduce alcoholic intoxication and addiction should direct their marketing towards promoting the fact that alcohol causes impotence. I would think for all those men of machismo and frat boys who measure their studliness in pints, that might be a bigger blow than cirrhosis and chronic pancreatitis.
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